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YOUR HEALTH In this report we take an in-depth look at dermatological conditions and NHL Hall of Fame inductee Darryl Sittler speaks out on cancer awareness. EDUCATE YOURSELF AND BECOME AN ADVOCATE TO BETTER YOUR HEALTH PHOTO: COLON CANCER CANADA AN INDEPENDENT SUPPLEMENT FROM MEDIAPLANET TO THE NATIONAL POST Psoriasis A disorder affecting more than just your skin Beating breast cancer Giuliana Rancic’s story of survival March 2013 How to keep your skin healthy and reduce risks of cancer C anada’s distinct cli- mate can make for dermatologic diffi- culties and derma- tologists across the country are work- ing to improve the quality of life for Canadians coping with some form of skin, hair or nail disorder. In Canada, there are 670 derma- tologists to care for almost 34 million people, which works out to a shock- ing ratio of about 50,700 patients per dermatologist. Extensive medical training and unique skills, put derma- tologists in high demand because of their ability to identify the intrica- cies in the skin, hair and nails, and treat numerous conditions. On occa- sion these conditions can mimic one another, often making diagnosis diffi- cult for those outside the dermatology specialty. What is dermatology? Dermatology is the division of medi- cine dealing with the skin, hair, nails, and mucous membranes, i.e. the lining inside the mouth, nose, eyelids, and genitalia. It’s a unique specialty that includes medical, surgical, and cosmetic components. A dermatolo- gist, like myself, is a physician who specializes in the diagnosis and treat- ment of more than 3,000 different dis- eases and disorders. More simply put, dermatology is the area of medicine that cares for what people see first when they meet someone new. Approximately 48.5 percent of Canadians are living with some form of the most common dermatologic conditions like acne, rosacea, eczema, hyperhidrosis (excessive sweating), and psoriasis. Dermatologic condi- tions affect our outward appearance and, although not often discussed, many tend to cause psychological side-effects or insecurities. Many common conditions, like those listed above, are not contagious but what they look like doesn’t matter as much as how they make a person feel on the inside or the perceived burden they pose to daily life. Often the degree of the psycho- logical impact directly correlates with the severity of the condition. Some of the psychological effects associ- ated with dermatologic conditions are social withdrawal, decreased self- esteem, low self-confidence, embar- rassment,depression,pre-occupation, and frustration. Advocacy The Canadian Dermatology Associa- tion (CDA) is committed to educating the public about various dermato- logic issues by providing informa- tion about treatment options and daily care, while the ultimate goal is to eliminate the social stigma. The latter is a task that cannot be accomplished alone, which is why the CDA works with patient groups like the Canadian Skin Patient Alli- ance — a patient-lead organization that provides a supportive commun- ity for those living with dermatologic conditions. One of the most serious issues of concern to dermatologists is skin cancer. In 2012, estimates indicated there would be more cases of skin can- cer diagnosed in Canada than breast, lung and prostate cancers combined (81,300:75,000). The increased preva- lence can be attributed, in part, to the growing popularity of using indoor tanning equipment to get the “Holly - wood glow” resulting in the diagnosis of malignant melanomas in patients still in their 20s. The Canadian Dermatology Associ- ation strives to educate Canadians on how to develop life-long healthy hab- its like everyday sun protection, how to do regular skin cancer self-examin- ations and care for their hair and nails. Remember the largest organ you have is your skin, take care of it. “Dermatology is a unique specialty that uses medical, surgical and cosmetic components to treat over 3,000 different diseases and disorders.” Dr. Gordon Searles President, Canadian Dermatology Association DR. GORDON SEARLES [email protected] 00 ON TAKING AN ACTIVE ROLE IN YOUR HEALTH 3 TIPS
8

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Page 1: March 2013 YOUR HEALTHdoc.mediaplanet.com/all_projects/11928.pdf · is your skin, take care of it. “dermatology is a unique specialty that uses medical, surgical and cosmetic components

YOUR HEALTH

In this report we take an in-depth look at dermatological conditions and NHL Hall of Fame inductee Darryl Sittler speaks out on cancer awareness.

educate yourself and become an advocate

to better your healthp

ho

to: C

olo

n C

an

Ce

r C

an

ad

a

AN iNdepeNdeNt SUppLeMeNt froM MediApLANet to tHe NAtioNAL poSt

psoriasisA disorder affecting more than just your skin

Beating breast cancerGiuliana rancic’s story of survival

March 2013

How to keep your skin healthy and reduce risks of cancer

Canada’s distinct cli-mate can make for dermatologic diffi-culties and derma-tologists across the country are work-ing to improve the

quality of life for Canadians coping with some form of skin, hair or nail disorder.

In Canada, there are 670 derma-tologists to care for almost 34 million people, which works out to a shock-ing ratio of about 50,700 patients per dermatologist. Extensive medical training and unique skills, put derma-tologists in high demand because of their ability to identify the intrica-cies in the skin, hair and nails, and treat numerous conditions. On occa-sion these conditions can mimic one another, often making diagnosis diffi-cult for those outside the dermatology specialty.

What is dermatology?Dermatology is the division of medi-cine dealing with the skin, hair, nails,

and mucous membranes, i.e. the lining inside the mouth, nose, eyelids, and genitalia. It’s a unique specialty that includes medical, surgical, and cosmetic components. A dermatolo-gist, like myself, is a physician who specializes in the diagnosis and treat-ment of more than 3,000 different dis-eases and disorders. More simply put, dermatology is the area of medicine that cares for what people see first when they meet someone new.

Approximately 48.5 percent of Canadians are living with some form of the most common dermatologic conditions like acne, rosacea, eczema, hyperhidrosis (excessive sweating), and psoriasis. Dermatologic condi-tions affect our outward appearance and, although not often discussed, many tend to cause psychological side-effects or insecurities. Many common conditions, like those listed above, are not contagious but what they look like doesn’t matter as much as how they make a person feel on the inside or the perceived burden they pose to daily life.

Often the degree of the psycho-logical impact directly correlates with the severity of the condition. Some of the psychological effects associ-ated with dermatologic conditions are social withdrawal, decreased self-esteem, low self-confidence, embar-

rassment, depression, pre-occupation, and frustration.

Advocacy The Canadian Dermatology Associa-

tion (CDA) is committed to educating the public about various dermato-logic issues by providing informa-tion about treatment options and daily care, while the ultimate goal is to eliminate the social stigma. The latter is a task that cannot be

accomplished alone, which is why the CDA works with patient groups like the Canadian Skin Patient Alli-ance — a patient-lead organization that provides a supportive commun-

ity for those living with dermatologic conditions.

One of the most serious issues of concern to dermatologists is skin cancer. In 2012, estimates indicated there would be more cases of skin can-cer diagnosed in Canada than breast, lung and prostate cancers combined (81,300:75,000). The increased preva-lence can be attributed, in part, to the growing popularity of using indoor tanning equipment to get the “Holly-wood glow” resulting in the diagnosis of malignant melanomas in patients still in their 20s.

The Canadian Dermatology Associ-ation strives to educate Canadians on how to develop life-long healthy hab-its like everyday sun protection, how to do regular skin cancer self-examin-ations and care for their hair and nails. Remember the largest organ you have is your skin, take care of it.

“dermatology is a unique specialty that uses medical, surgical and cosmetic components to treat over 3,000 different diseases and disorders.”

Dr. Gordon Searlespresident,Canadian dermatology Association

DR. GORDON SEARLES

[email protected]

00StepS/tipS

oN tAkiNG AN Active roLe iN your HeALtH

3tipS

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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt2 · MArCH 2013

CHALLEngEsThe mental and social consequences of the leprosy effectSometimes when I awaken I

cringe inwardly as I remember who I am… who I have become. I can feel my skin... feel the itch, the burn, the pain... the itch… the itch….

As I prepare for my day, carefully applying topical treatments to the areas of my body, I sigh. It’s often messy and uncomfortable and it can take up to an hour some days, this care and tending, and yet often the results are slow to come. Then I don my great disguise — the one that will hopefully carry me though my day appearing ‘normal.’

Living without hiding Like the millions of other Canadians living with a dermatological condi-tion that affects how our hair, skin or nails look and feel, I am an expert at camouflage. We’re all great at hiding, or diverting attention away from our affected areas and expert at burying the complex feelings that come with living with a skin disease.

We learn quickly that if we don’t cover up, people move away from us on the bus, or we get asked to leave a swimming pool, or athletic club, because the sight of us makes other patrons uncomfortable. People fear catching the hideous skin affliction. I call it the leprosy effect.

So most people with skin dis-ease hide it, for most of us have the experience of being shunned, stared at, pitied, denied jobs or relation-ships, and we grapple with feelings of shame and periodic low self-esteem. Some skin patients literally become hermits. Some wear long clothes and hats in the heat of sum-mer. If skin disease comes to us in youth, our social development can be affected. Even teens with ‘just’ acne have higher rates of suicidality.

Defeating the stigmaBecause no one talks about it, the

impact of skin diseases is hugely underestimated. Interestingly, a study showed that the impact on mental health of living with psoria-sis, a systemic skin condition affect-ing a million Canadians, is emotion-ally worse than living with a diag-nosis of arthritis, congestive heart failure, and even cancer.

Because its ‘just skin’, there isn’t the same investment in research and so treatments and cures are hard to come by. So there is a feeling of hopelessness that we’re saddled with a disease that won’t get the same attention that goes to those with, say, breast cancer. Did you know that if you lose your hair to chemo, in Canada you qualify for a wig. If you lose your hair to alopecia, a hair loss disease where your hair is unlikely to grow back, it’s not covered.

There are 3000+ dermatological diseases, most of which are non-communicable, and many of which are rare. Many have names that are unpronounceable. Many are chronic, meaning once diagnosed, they are with you for life.

In our society where our health and attractiveness as a human being is judged by the healthy glow of our skin and hair, skin with scales or pustules, burned, scarred skin and bald heads

or excess facial hair ( especially on women) can be seen as repulsive and somehow scary.

To make things worse, when we are diagnosed, or are struggling with an outbreak and feel conspicuous, or we have a child who can’t sleep because their skin feels on fire, and we want to grieve the loss of the ‘normal’ life

we had envisioned for ourselves, we’re told to relax, “it’s just skin — it’s not cancer.” The inference is that

ABcDe’s of early detection5 keys to self-examination

We recommend

pAGe 5

Moving mountains p. 6Life after a colostomy and what can be accomplished.

Managing cancer p. 8Stopping the spread of cancer.

YoUr HeALtH1St editioN, MArCH 2013

responsible for this issue:publisher: Leah [email protected]: michael [email protected]: Laura [email protected] contributors: canadian cancer Society, canadian Skin cancer Foundation, canadian pempihigus and pemphigoid Foundation, ellen choe, Julian dobranowski, eric marsden, Indrani nadarajah, christine Janus, Joe rosengarten, dr. Gordan Searles, Gladys Wasylenchuk, Jeff Wrana

photo credit: All images are from iStock.com unless otherwise accredited.

Managing Director: Joshua [email protected] Manager: maggie ritchie [email protected] Developer: Jessica [email protected]

Distributed within:national post, march 2013this section was created by mediaplanet and did not involve the national post or its editorial departments.

Mediaplanet’s business is to create new customers for our advertisers by providing readers with high quality editorial contentthat motivates them to act.

ChRiStiNE JANuS

[email protected]

FoLLoW US on FAceBooK And tWItter!www.facebook.com/MediaplanetcAwww.twitter.com/MediaplanetcA

perhaps we are being vain (really?), and that we should get on with life, and most of us ultimately do so, only occasionally feeling guilty for feel-ings of despair that creep through when we experience the leprosy effect.

It’s time for us to come out of the closet and help erase the stigma asso-ciated with skin diseases by showing our skin and nails and hair issues to others, and gently explaining over and over, that unlike leprosy, which was thought to be contagious, most skin diseases simply aren’t.

The Canadian Skin Patient Alliance members envision a world where all of us can walk without shame in shorts and t-shirts, just like everyone else.

“people fear catching the hideous skin affliction. i call it the leprosy effect.”christine Janusexecutive director, Canadian Skin patient Alliance (CSpA)

characterized by dry, flaky, inflamed and extremely itchy skin, eczema is a chronic con-dition that can vary in nature and severity.

Eczema affects between twenty and twenty five percent of Canadians at some point in their life, but its root causes remain unknown.

“Atopic eczema is the most com-mon form of eczema and is closely linked with asthma and hay fever. Eczema can affect anyone,” explained Amanda Cresswell-Melville, Execu-tive Director, Eczema Society of Can-ada. “Many young people with eczema will outgrow the condition, but some people will have it for the rest of their lives. Doctors are not sure whether it’s a rash that itches, or an itch that rashes.”

Self treatmentFor a sufferer of eczema, being pro-active and following a self-treatment

regime is imperative. There are some simple processes that people can work into their daily routine to help manage their condition and reduce irritability. Cresswell-Melville said, “there’s a lot of skincare involved with eczema. The general recommenda-tion is to bathe at least once a day and apply a good quality, specially formu-lated moisturizer at least twice a day. Sticking to this routine is one of the most important things that you can do to keep your skin under control.”

As well persevering with self-treat-ment,  Cresswell-Melville believes that it’s important for sufferers to have faith in their doctor and the treatments that they prescribe.

“We often hear from eczema suffer-ers who are afraid to use the topical treatments that their doctor has pre-scribed. We recommend they work with their doctor and not be afraid to use topical treatments,” she said.

Dry skinPeople suffering with dry skin can carry some of the more mild symp-toms of eczema, but in many cases dry skin can be easily managed with mois-turizing and avoiding harsh soaps and irritants. “People with eczema typically have dry skin, but not every-one with dry skin will have eczema,” explained Cresswell-Melville.

The decreased level of humidity in the cold winter air is a common cause of dry skin. Installing a humidifier in your home and covering up sensi-tive areas of your skin when you go out is a good way of combatting this. Extremely hot showers may be a great way of washing away the stresses of a hard day, but they’re ill advised; the

high temperatures can quickly dry out your skin’s natural oils.

Dry skin is very common in elderly people. The decreased activity in the sweat and sebaceous glands reduces the production of moisturizing oils and this can lead to itchy, sore and cracked skin. Embracing a healthy lifestyle when young is a good way of reducing the risk of living with exces-sively dry skin when elderly:  avoid smoking, over exposure to the sun and drink good amounts of water everyday.

“For the elderly population it can be a difficult and frustrating condition to manage,” said  Cresswell-Melville. “Anyone with dry skin can benefit from the use of a good quality, rich moisturizer. If you have dry skin it’s important to keep it hydrated because well hydrated skin is less likely to be itchy, and reducing itchiness can reduce flare ups.”

Taking control of your eczema and dry skin

JOE ROSENGARtEN

[email protected]

Pemphigus and pemphigoid are rare, blistering diseases of the skin and mucous membranes (eyes, throat, genitals, mouth). In pemphigus, antibodies attack desmoglein — the “glue” of the upper layers of the skin (epidermis). The skin cells detach leading to burn-like lesions or blisters that do not heal.

Large areas of the body can be affected and need treatment at a Burn Centre. Pemphigus can be fatal if left untreated and blisters spread and become infected. Early diagnosis is important. Aggressive treatment strategies are needed. There are several different types of pemphigus. Pemphigus Vulgaris is most common.

two major formsThere are two major forms of pem-phigoid — Bullous Pemphigoid and Cicatricial Pemphigoid. The type depends on which antibodies are produced and in which layer of the skin blisters occur. Bullous Pemphigoid patients have itching that may be painful with blisters appearing on the trunk, back, arms and legs. Cicatricial Pemphigoid occurs on mucous membranes. Gums are commonly affected. And if left untreated it can be fatal.

No single medication or com-bination of medications guarantees remission. Patients need to know options and work with their derma-tologist and other healthcare pro-fessionals to determine an optimal strategy.

The number of Canadians diagnosed with these diseases is unknown. To support patients and their families to deal with these diseases, the Canadian Pemphigus and Pemphigoid Foundation was established.

dId yoU KnoW?

SOuRCE: CANADiAN PEmPhiGuS

AND PEmPhiGOiD FOuNDAtiON

[email protected]

Amanda cresswell- Melvilleexecutive director, eczema Society of canada

When Annette Cyr was growing up in the 60s and 70, spend-

ing hours under the sun’s rays was a regular occurrence; she didn’t give it a second thought.

“I remember in my teenage years, trying to keep up with my girlfriends,” said Cyr, now Chair of the Melanoma Network of Canada. “We would go to the beach or the pool to do our tan-ning.  I was always burning; it was a constant. There was not the level of awareness back in those days.”

There was no way for Cyr to envis-age the repercussions of her tanning. In 2001 she was diagnosed with a low-level melanoma: she had a relatively simple surgical procedure and that, she thought, was the end of it. Relapses in

2007, and recently in 2012, were not so easy to treat. She had to have a series of major surgeries and skin grafts.

“In 2007 I was off of my feet for 6 months and, being self-employed at the time, it was quite frightening. I was so stressed, my heart rate went up; I was terribly afraid,” said Cyr. “I was being told by the doctors that the outlook didn’t look good. It’s hard for a person to process that kind of informa-tion.”

Since starting the Melanoma Net-work of Canada in 2009, Cyr has worked tirelessly to educate Canadians about the importance UV protection. “Your skin never forgets,” she said.  “You carry with you whatever UV exposure you’ve had. People don’t seem to put it into their minds that it’s radiation.”

Cyr will continue to raise awareness of the dangers of UV rays, and she’s not likely to surrender in her personal battle with melanoma either. “It keeps reminding me that this is not an easy disease to tackle, but, little does it know: I’m as relentless as it is.”

InSpIrAtIon

Annette cyr and kathy Barnard are intent on improving the quality of life for every canadian affected by melanoma.

It was after returning from a baseball trip to Australia in 2002 that  Kathy

Barnard, founder of The Save Your Skin Foundation, found two lumps on her elbow. When one of them turned purple a plastic surgeon recommended an immediate ultrasound. The lumps were removed, both thought to be benign.

Spring 2003: Barnard gets a phone call from her general practitioner. “I went in, expecting to hear that everything was fine. My GP told me that I had to go home and get my affairs in order: I had metastasis melanoma.”

That phone call was the start of Bar-nard’s journey. After her first bout was treated, she went back to work; she thought she was recovered. In 2005, doctors discovered that the malignant

melanoma had spread to her kidney, liver, lung and adrenal gland. “My whole family got on a plane and flew to Brit-ain,” she said. “We had what we thought was going to be my last ever family reunion.”

Since recovering from that Barnard, has suffered further relapses. She’s fought her way onto a series of clinical trials that have provided her with life saving treatments. “The last drug that I was given is an immunotherapy treat-ment, it boosts your immune system to fight the disease by itself,” she said.

Barnard hasn’t been satisfied to sim-ply fight her own melanoma, to think of only her own recovery.  Since 2005, she’s been campaigning to ensure that suf-fers of melanoma receive the financial and emotional support that they need.

“Having my family around me, being positive, was so important. That’s why the foundation is now so important. We need to educate people about skin care, to raise awareness. I need to let people know that melanoma is not the death sentence that they may think it is. We can survive this,” she said.

JOE ROSENGARtEN

[email protected]

Annette cyrchair, the melanoma network of canada

kathy BarnardFounder,Save your Skin Foundation

BreAk tHrouGH tHe MoLD challenging the notions around the leprosy effect.

BreAk DoWN StiGMA By

SpeAkiNG out

1tip

Pemphigus and pemphigoid

Their journeys

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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt

CHALLEngEs

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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt4 · MArCH 2013

doesn’t cause irritation or side effects, because, as Dr. Barankin explained, “if treatment is toler-ated well, the compliance will be higher and the results will be better.”

The psychological effects of acne cannot be underestimated. For some teenagers, going through a period of life that is stressful enough already, it can be hard to handle. “I’ve had many patients who skipped school, or didn’t date because they were embarrassed. There are increased rates of anxiety, depression, and sui-cidality in patients who have acne. But, there are studies that show that aggressive treatment of acne significantly improves the way that people feel about themselves,” said Dr. Barankin.

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1 Tanno O, Ota Y, Kitamura N, Katsube T, Inoue S. Nicotinamide increases biosynthesis of ceramides as well as other stratum corneum lipids to improve the epidermal permeability barrier. British Journal of Dermatology. 2000; 143: 524-531.

2 Werz, P.W. Lipids and barrier function of the skin. Acta Derm Venereol 2000; Supp 208: 7±11.

3 Choi MJ, Maibach HI. Role of ceramides in barrier function of healthy and diseased skin. Am J Clin Dermatol. 2005;6(4):215-23.

acne: not just your child’s condition

Psoriasis: more common than you think

Suffered by between eighty five and ninety percent of teenagers, acne is a hormonal skin disease that can affect the face, chest, back, and shoulders. Although adult acne is fairly common, especially in women, in most cases the condition is completely cleared up by the age of twenty. In certain instances acne can leave scarring and marks on the skin.

“It’s generally related to the secre-tion of testosterone, which revs up when puberty begins,” said Dr. Benjamin Barankin, Medical Direc-tor and Founder of Toronto Derma-tology Centre. “As a result of this increase, you start to produce more

oil, or sebum.  A bacteria on the skin called P.acnes can then start to over-grow on all of this excessive oil; your body then develops an immunologic reaction to the bacteria and acne inflammation ensues.”

treatment optionsThere are various types of treatment that can be used to treat acne. For mild cases, topical treatments, such as creams and gels are used, “the topical therapies include antibiot-ics, benzoyl peroxide and vitamin A, otherwise known as tretinoin. You can also have combinations of any of those three. If somebody has deep acne you’re generally going to think about adding a pill to work alongside topical therapy,” said Dr. Barankin.

psoriasis, an auto-immune disorder, can be so severe that it can cause severe depres-sion, and even shorten a per-son’s life.

One thing that really troubles Chris-tine Janus, executive director of the Canadian Skin Patient Alliance (CSPA) is that some people still dismiss psor-iasis as a skin problem, and sufferers should “just get over it”.

“This over-simplification couldn’t be further from the truth,” she stresses. Psoriasis is a complex auto-immune disorder, which can ravage the body if it is not treated.

About 2-3 percent of Canadians suf-fer from psoriasis. “We know there’s a lot of association with other disorders,

says Dr Charles Lynde, associate pro-fessor of medicine at the University of Toronto. People with more severe psoriasis have an increased incidence of other diseases like psoriatic arth-ritis, cardiovascular disease, hyper-tension, diabetes, and Crohn’s disease.

Psoriasis can also affect the finger-nails and toenails, causing pitting, thickening, and irregular nail con-tours. In people who have skin psor-iasis, between 10-55 percent have

Sticking with treatmentSufferers may see positive results quickly, but it’s important that they stick to their treatment to get the best possible results. It’s also helpful to find a treatment that

psoriatic nail disease.  People with severe psoriasis will die

four to five years earlier, says Dr Lynde. While diet does not seem to be a fac-tor, “we do know is that alcohol makes it worse.” There’s also a link between being overweight and getting the dis-ease in the first place, or being over-weight and exacerbating the disease, he says.

You can often spot a person with psoriasis — they’re the ones wear-ing long sleeves and long pants in the summer, says Janus. The emotional toll can be crippling — many patients feel shame about their condition, and up to 60 percent will develop depression.

treatment optionsThankfully, coal tar is rarely used today. Instead, topical steroids are more widely used. Phototherapy is also beneficial but it’s not so widely used here because it’s not well reim-bursed, explains Dr Lynde.

Cyclosporine, usually prescribed

Spot SoLUtIonS

nEws

JOE ROSENGARtEN

[email protected]

THAT SUNTAN CAN BE DEADLY

(289) 242-2010melanomanetwork.ca

We are a national organization dedicated

to the prevention and awareness of melanoma

and skin cancer. We provide support and

resources for patients and their families.

Melanoma is a potentially deadly form of skin cancer. Protect yourself in fi ve ways from melanoma and skin cancer:

SUN SAFETY TIPS

Seek shade between 10:00am and 3:00pm

Wear sun protective clothing that covers as much of your body as possible

Put on a broad-brimmed hat that shades your face, neck and ears

Wear wrap-around sunglasses

Apply SPF30+ broad spectrum sunscreen liberally to clean, dry skin, at least 20 minutes before being exposed to the sun, and reapply at least every two hours when outdoors

melanomanetwork.caMelanoma is a potentially deadly form of skin cancer. Protect yourself in fi ve ways from melanoma and skin cancer:

for transplant patients, is considered one of the most effective treatments for psoriasis. However, long-term use of cyclosporine carries a risk of kidney, liver and other problems. Consequently, cyclosporine is usually limited to short courses.

Methotrexate has been used to treat moderate to severe psoriasis for over 50 years. It suppresses the immune system to prevent skin inflammation.

For people with nail psoriasis, topical treatments containing equi-setum arvense (horsetail) plant extract have been shown to effect-ively smooth nail surfaces. Products including ingredients like Methyl-sulfonylmethane, which acts as a sulfur donor to the nails, can be seen to harden and even promote proper nail growth. These combined with Hydroxypropyl-Chitosan to act as the carrier of the active ingredients have proven to be an effective com-bination for psoriatic nail disease.

BiologicsBiological response modifiers are an effective option for patients with mod-erate to severe psoriasis. Biologics block interactions between certain immune-system cells. Most are injected under the skin.  Another biologic, infliximab, is administered intravenously.

Some, like adalimumab, etanercept and infliximab, block the action of tumour necrosis factor (TNF) made by the immune system, an excess of which can cause skin inflammation. Inter-leukin inhibitors, such as ustekinumab, can prevent proteins (interleukins) from causing the body’s immune sys-tem to attack the skin and nails.

Better education requiredGiven the progress in treatment, the CSPA is working hard to educate all people with psoriasis to see a doctor, says Janus. “This is a shame they do not have to live with.”

“there are increased rates of anxiety, depression and suicidality in patients who have acne.”Dr. Ben BarankinMedical director and founder, toronto dermatology Centre

Dr. charles LyndeAssociate professor of medicine, University of toronto

iNDRANi NADARAJAh

[email protected]

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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt MArCH 2013 · 5

Skin cancer is preventable! that’s the message of the canadian Skin cancer Foundation and its founder, Dr. Barry Lycka, Dermatologist. “Sun safety is the first line of defence: seek shade or wear long sleeves, pants and hats during peak hours and wear sun screen any time you are out of doors during daylight hours, no matter the season.”

insigHT

Although painless when ad-ministered, the high-energy rays that radiation therapy uses to kill cancer cells can cause damage and irritation to skin.

“The radiation harms the ability of cells to reproduce, they can’t repli-cate as usual,” explained Dr. Michael Lock, Chair, Division of Radiation Oncology, London Regional Cancer

Program. Dr. Lock continued, “the skin breaks down quicker because it is not reproducing like it usually does.”

Radiation can cause the skin to become irritable and itchy in the area where the treatment is being given. The skin may develop a red pallor and become sensitive, swol-len and prone to peeling.

“There is a continuum in the effects experienced,” said Dr. Lock. “In the first week there will usually just be a dryness to the skin. By the fourth, fifth and sixth week of treatment the skin may start to breakdown and, in the worst-case scenario, ulcers may develop.”

your skin changesSkin problems are most likely to occur in areas where friction is most com-mon: underneath the arms, between the legs and underneath the breasts. Patients are advised to use a cream to maintain moisture in their skin and to pat themselves down gently with a towel after washing.

Although in some cases there may be long-term dryness or changes in the colour of the skin, most patients

will notice their skin returning to normal around five weeks after radia-tion therapy has finished.

Improvements being made in radiation therapy that aim to mini-mize skin damage have the potential to make the treatment process much easier to manage for patients.

Dr. Lock said, “patients and phys-icians can sometimes dismiss skin problems as minor, but they can have a significant psychosocial effect: a major impact on a patient’s quality of life. Even when skin problems appear minor, they can still have a major impact on psychological well being.”

SKIn rAdIAtIon

SOuRCE: CANADiAN SkiN

CANCER FOuNDAtiON

[email protected]

JOE ROSENGARtEN

[email protected]

BiologicsBiological response modifiers are an effective option for patients with mod-erate to severe psoriasis. Biologics block interactions between certain immune-system cells. Most are injected under the skin.  Another biologic, infliximab, is administered intravenously.

Some, like adalimumab, etanercept and infliximab, block the action of tumour necrosis factor (TNF) made by the immune system, an excess of which can cause skin inflammation. Inter-leukin inhibitors, such as ustekinumab, can prevent proteins (interleukins) from causing the body’s immune sys-tem to attack the skin and nails.

Better education requiredGiven the progress in treatment, the CSPA is working hard to educate all people with psoriasis to see a doctor, says Janus. “This is a shame they do not have to live with.”

is your skin ready for treatment?

“even when skin problems appear minor, they can still have a major impact on psychological well being.”Dr. Michael LockChair, division of radiation oncology, Associate professor, Western Univerity

Detecting skin cancer early is critical

He also advises avoiding the use of tanning beds as the ultra violet radia-tion emitted by them can be up to four times that of the sun.

“And early detection will help ensure that skin cancers that are relatively easy do not become life threatening,” he goes on to say.

Self examinationExamining your skin on a regular basis could lead to early detec-tion, treatment and in most cases,

positive outcomes. The Canadian Skin Cancer Foun-

dation recommends self exam-inations at least monthly, checking your whole body as skin cancer can show up on areas that rarely see the sun.

■■ Examine your body front and back as well as left and right sides — ask for someone’s help or use a mirror

■■ Check forearms, underarms, arm-pits and the palms of your hands

■■ Look at the back of your legs (right up to your buttocks), soles of your feet and between your toes

■■ Examine the back of your neck and, using a mirror or someone’s help, check your scalp (parting your hair to get a better look)

early detection is keyDr. Lycka explains that skin can-cers take many forms, “if you are concerned about any changes to existing moles or any new spots or lesions on your skin, contact your doctor immediately.

Early detection can mean success-ful treatment with a minimum of invasion and scarring and may, in some cases, prevent death.”

FuN iN tHe SuNBe sure to cover up and wear sun screen.

do yoU KnoW WhAt to LooK For?

■■ Asymmetry:  two sides of a mole look different when you draw a line across the middle

■■ Border: irregular, wavy or jagged edges

■■ colour: multiple shades of brown

■■ Diameter: larger than an eraser on the end of an HB pencil (which is about 6mm); however, some skin cancers can be smaller, so check for other signs as well

■■ evolution: changes in the size, colour or shape over time, or itching, tenderness or bleeding

?the ABcDes of early detection of melanoma

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of being proactive in getting screened and tested.”

The family has also created the Wendy Bear; a cuddly toy that is sold to raise money for sufferers of colon cancer. “It provides money for fam-ilies who have a loved one who wants to die at home, but don’t have the finances to do so. The bear also keeps Wendy’s name, and the message, out there,” said Sittler.

Sittler now spends his time reiter-ating the importance of early detec-tion, encouraging people to be aware of the early signs of colon cancer. “When your family has a history of colon cancer you have definitely got to get screened at an early age. Don’t be afraid to talk about it, and always be proactive. People don’t like the idea of having a colonoscopy but I’d rather have the colonoscopy than deal with the effects of chemotherapy.”

insPiRATiOn

paul riome had a choice to make when he heard the words “you have cancer.” you can do one of two things: you can throw your hands up and say that’s it, or you can fight for your life. paul made the heroic choice to have a colos-tomy and shares his journey after surgery. His life has just begun.

It was a good trade. I had ignored daily rectal bleeding for 2 years, assuming only hemorrhoids, and refusing all medical examinations and procedures. I did eventually succumb to a colonos-copy, and was diagnosed with Invasive Adenocarcinoma (Rectal Cancer), with prescribed treatment of Abdomino-Perineal Resection (surgery including a permanent colostomy). At the age of 59, I had cancer and my life-expect-ancy was uncertain.

Very early in my adventure, I resolved that “I will live. After surgery I will do everything that I could do before surgery.” I was inspired by Rob Hill of IDEAS, who showed tremen-dous determination to recover from daunting medical challenges, climbed real mountains, and now works tire-lessly giving-back by inspiring others to face their own challenges and move their own mountains. Exactly 4

months after surgery, I was back play-ing hockey with the same tenacious grit as before.

My accomplishmentsThis gave me the freedom and atti-tude-adjustment to actually live and experience adventures that had been dormant on my bucket-list. I hiked the West Coast Trail on Vancouver Island and Lake O’Hara in the Canadian Rock-ies. I surfed and snorkeled in Mexico and Costa Rica. I trekked 60 days in rugged Nepal and summited Island Peak in Nepal (6189m or 20,306ft).

My journey was certainly life-changing and in a good way. I appreci-ate life more than before. I have simpli-fied life to do more of what I want to do, and less of what others think I am obli-gated to do. When embarking on new life-experiences, or again experien-cing treasured places or activities, I am humbled and thankful for the oppor-tunity given to me. A colostomy is not as good as the original equipment, but I get to live. Living is everything.

Three years ago my doctor told me I could have a perfectly normal life with a colostomy.

I didn’t believe him then. I do believe him now.

hoW I mAde It

PAuL RiOmE

[email protected]

colon Cancer is the most com-mon cause of death from can-

cer amongst Canadians, but, if dis-covered in its early stages, it is pre-ventable in ninety per cent of cases.

NHL Hall of Famer and former Toronto Maple Leaf, Darryl Sittler, has experienced the pain and tra-gedy of losing a loved one to cancer. His wife, Wendy, was aged just fifty-three when she lost her battle with colon cancer in 2001.

When Wendy was first diagnosed with colon cancer in 1998, she and Darryl researched the disease and all of the possible treatments. They got involved with awareness cam-paigns and Wendy was an inspira-tion to everyone around her, includ-ing Darryl.

“People loved her, she had a big smile and she was full of life. She was a real battler and fighter

through the whole thing. She always believed that she would be the one to have a miracle and be cured, but she never got there,” said Sittler.

High spiritsAlthough ill, and suffering from the effects of treatment, Wendy con-tinued to raise awareness of colon cancer. “At a national campaign that was being launched Wendy got up to talk, she wasn’t comfortable in the limelight and didn’t like public speak-ing, but she got up and she said, quite emotionally, that if she could make a difference to one person’s life, then this whole campaign would be worth it. The emotion of that speech has always stuck with me.”

Wendy is never far from the thoughts of Darryl and his three children. She has inspired him to continue the quest of educating people about colon cancer and the importance of CRC screening. “Help-ing others has certainly made a dif-ference to our family. It was my idea to get my daughter, Ashley, involved in an advertising campaign, the idea being to get the younger generation to instill in their parents the importance

JOE ROSENGARtEN

[email protected]

darryl Sittler believes in a positive future for colon cancer

The decision of a lifetime

the FUtUre oF oncoLoGy

Turning a vision into a reality: eradicating cancer in Canada

coLoN cANcer cANADA’S puSH For your tuSHABove: co-Founder of ccc Amy elmaleh, Darryl, Darryl’s wife Luba and Hugh Burrill from city tv. LeFt: Darryl and Wendy Bear. PhotoS: Colon CanCer Canada

For 75 years the canadian cancer Society has supported canadians in the fight for life. We’ve been relentless in our commitment to prevent can-cer, fund research and help canadians touched by cancer.

In the 1940s, only about one in four people diagnosed with cancer sur-vived at least five years. Today, thanks in part to the work of the Society, that number is closer to two out of three. The rate of new cases for most types of cancer is stabilizing or declining. And with the exception of lung cancer in women, death rates for most major cancers have declined over the past decade.

Research has contributed answers to many of the pieces of the cancer puzzle, and we’re constantly learn-ing more about what causes cancer, how to prevent it, how it spreads, how best to treat it and how to improve the quality of life of people living with and beyond cancer. Since cancer is more than 200 different diseases, it is unlikely there will be one single, uni-versal treatment or cure. It remains critical that research continues so we can find more ways to prevent, detect and treat all types of cancer.

We know that about half of all cancers can be prevented through healthy living and policies that pro-tect the health of Canadians. That’s why the Canadian Cancer Society

is investing in cancer prevention research, as well as working with communities across Canada to make sure the healthy choice is the easy choice — at work, at home and at play. We must continue to fight for public policies that make healthy living possible and protect Canadians from cancer-causing substances.

understanding diagnosisFor people diagnosed with cancer and their loved ones, we provide a wide variety of information and support services to reduce anxiety, inspire hope and offer comfort. Our top-notch programs and services are offered from coast to coast. With these pro-grams and through our leading-edge research and significant public policy achievements, the Society continues to make a meaningful difference to Canadians.

All Canadians should feel proud of, and optimistic about, the progress that has been made against cancer. During April — the Canadian Cancer Society’s Daffodil Month — we will be working hard, as always, to raise funds and awareness so that progress can continue. Working with Can-adians, the Society envisions a world where no one fears cancer. And with your continued support, we believe this vision will become a reality.

SOuRCE: CANADiAN

CANCER SOCiEty

[email protected]

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In Canada last year, an estimated 186,400 new cases of cancer were diagnosed and 75,700 deaths occurred from the disease. This makes cancer the leading cause of death for Can-adians but screening and early detec-tion can help change the progression of the disease. This would help reduce the overall burden that cancer has on the entire healthcare system, but more importantly it would make a difference in the lives of men and women and their families and com-munities.

ScreeningCurrently cancer screening is recom-mended for breast cancer, cervical cancer and colorectal cancer, but there is not just one test that can detect all forms of cancer so the appropriate type of screening is required.

“Cancer screening is an effective way of finding early stage disease in breast cancer before symptoms may even exist,” said Scott Living-stone, Chief Executive Officer for the Saskatchewan Cancer Agency. “In the case of colorectal and cer-vical cancer screening we are look-ing to actually find precancerous changes that left untreated could lead to cancer.”

Advancements in breast cancerThe Saskatchewan Cancer Agency provides digital mammograms for asymptomatic women over the age of 50. With regular screening, chan-ges in the breast can be detected even when they are too small for a woman or her doctor to feel or see. The Screening Program for Breast Cancer has screening Centre’s in Regina and Saskatoon as well as

in satellite offices in various com-munities and operates a mobile bus that travels the province. Using digital mammography equipment approximately 38,000 mammo-grams are performed each year through the program.

preventing cervical cancer The Prevention Program for Cer-vical Cancer encourages women between the ages of 21 and 69 to get regular Pap tests from their health care provider. Regular Pap tests can detect abnormal cervical cell that would otherwise go unnoticed and that could develop into cancer if not treated.

colorectal cancer options The Screening Program for Colo-rectal Cancer, which started in 2009 is now available province wide and will screen asymptomatic men and

of being proactive in getting screened and tested.”

The family has also created the Wendy Bear; a cuddly toy that is sold to raise money for sufferers of colon cancer. “It provides money for fam-ilies who have a loved one who wants to die at home, but don’t have the finances to do so. The bear also keeps Wendy’s name, and the message, out there,” said Sittler.

Sittler now spends his time reiter-ating the importance of early detec-tion, encouraging people to be aware of the early signs of colon cancer. “When your family has a history of colon cancer you have definitely got to get screened at an early age. Don’t be afraid to talk about it, and always be proactive. People don’t like the idea of having a colonoscopy but I’d rather have the colonoscopy than deal with the effects of chemotherapy.”

insPiRATiOn

cancer is a challenging illness affecting too many canadians. While tremendous advances have been made in the way it is diagnosed and treated, more needs to be done in order to make cancer “history.”

Many non-conventional cancer therapies have gained recogni-tion over the past several years as research grows on their potential to positively impact the lives of patients by improving treatment outcomes. In 2012 the National Cen-ter for Complementary and Alterna-tive Medicine  (NCCAM) in the United States funded an estimated 80 million dollars for research into non-conventional therapies for various illnesses including cancer.

Naturopathic doctors are the experts in non-conventional ther-apies. They are highly trained and regulated health professionals, many with specialized training and practice emphasis in cancer care. There are various ways an experi-enced naturopathic doctor can assist in the survivorship pathways for cancer patients. The following are some examples of how naturo-pathic medicine can help:

preventionOne of the key tenets of naturo-pathic medicine is prevention. Estimates by organizations like the World Cancer Research Fund and the American Cancer Society show that more than half of all cancers are preventable. Naturopathic doc-tors can create patient specific can-cer prevention programs that take into consideration an individual’s risk along with diet, lifestyle, and environmental factors.

Supportive treatmentsThere are many non-conventional treatments that have been shown to combine well with chemother-apy and radiotherapy. Locoregional Hyperthemia (LRHT) is a prime example. LRHT involves the specific heating of cancerous tissue using various methods. Numerous clinical trials have validated that LRHT has a direct inhibitory effect on tumors and when used in combination with chemotherapy and radiation ther-apy can increase their efficacy.

Managing side effectsWhile conventional therapies like chemotherapy, targeted therapies and radiation therapy are essential to treatment success they come with significant side effects. Nat-uropathic medicine can provide supportive therapies that help to minimize treatment related side effects without compromising their effectiveness. European Mistletoe (EM) has been used for almost 90 years in the supportive care of can-cer patients in many countries in Europe. There have been hundreds of studies that have investigated EM and they have shown that it can substantially reduce side effects of conventional therapy, improve patient’s quality of life, and may contribute positively to survival.

Learn moreThese are only a few examples of how naturopathic medicine can aid in the care of patients on their pathway to health and recovery. It is important for patients interested in naturopathic medicine to seek the advice of licensed naturopathic doctors with specialized focus in cancer care. For a list of naturo-pathic doctors in your area visit the websites for Oncology Association of Naturopathic Physicians or the Canadian Association of Naturo-pathic Doctors.

KnoWInG yoUr treAtment optIonS

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strength in the face of adversity

Giuliana rancic, tv person-ality from shows such as Live from the red carpet and Fash-ion police, was brave in facing her diagnosis and overcoming Breast cancer. She took the time to share her experience with you.

1. How has being a breast can-cer survivor aided in your new challenge of motherhood?

Breast cancer was one of the most difficult chal-lenges I have ever been

through. Motherhood on the other hand, is the best thing that has ever happened to me.  When I am holding Duke in my arms, noth-ing else in the world matters.  Ever since my diagnosis, I prom-ised myself to live each day to the fullest and not take one day for granted and that’s what I am try-ing to do each and every day.

2. How have you supported cancer research since you beat your cancer?

Since my diagnosis, I have worked closely with BCRF, the breast cancer research

foundation.  I designed a necklace for LOFT recently that raised 3 mil-lion dollars for the foundation, an accomplishment that made me incredibly proud. I also work closely with Bright Pink which is a non-profit organization based in Chicago.   Their  mission is to spread awareness and share the importance of early detection. I was very fortunate to have found my breast cancer early and have

made it my mission to encourage all women to be proactive about their health. I’m also excited to be launching Fab-U-Wish soon, a pro-gram to grant celebrity and fash-ion inspired wishes to women bat-tling breast and ovarian cancer.

3. in what ways has being in the public eye shaped your battle with cancer and your triumph?

When I was first diagnosed, I wasn’t sure if I wanted to go public with it. But after

a few days, I realized that I have an incredible platform on E! News,

Fashion Police, Giuliana & Bill and my social network sites to

share my story to try to help people.  I realized that if

by sharing my journey

helped even one person, than it was all worth it.  I am always so incredibly touched when a women comes up to me and tell me that she got her first mammogram because of me or that she found her breast cancer early because of my story.

4. What advice can you give to newly diagnosed women?

Attitude is everything.  Of course, our natural first reac-tions are sadness, fear and

anger, but it is so important to get your-

self to a positive space because that is what will get you through.  A positive attitude is a very powerful thing.

5. in what way has beating cancer changed you?

As I said before, I now try to just live each day to the full-est and focus on the import-

ant things in life. I have an amazing husband and beautiful baby boy, great family and friends and the career of my dreams.  I’m happy and healthy and looking forward to the future.

ELLEN ChOE

[email protected]

ERiC mARSDEN, BSC ND

NAtuROPAthiC DOCtOR,

CLiNiC DiRECtOR mARSDEN CENtRE

FOR NAtuROPAthiC ExCELLENCE

[email protected]

darryl Sittler believes in a positive future for colon cancer

The role of naturopathic medicine in cancer care

“i realized that if by sharing my journey helped even one person, than it was all worth it.”

The fight against cancer may be this generation’s most important battle.  As some of the best medical and sci-entific professionals in Atlantic Can-ada collaborate to develop a better understanding of its genetic origins, there is a hope that we’re taking pro-

gressive steps towards developing a cure for cancer.

“Some of the research that we are conducting now is quite exciting,” said Dr. Rodney Ouellette, President and Scientific Director, Atlantic Can-cer Research Institute (ACRI). “Cells put out little packets of informa-tion called microvesicles to com-municate amongst themselves, and cancer cells put out even more than normal cells do. We’ve developed a method whereby we can extract these microvesicles from blood or urine quickly and efficiently. They give us important information about the cancer cell that produced them.”

increased treatment optionsIn terms of cancer treatment, person-alized medicine is about more than delivering specific care on a patient-by-patient basis. It’s about getting to the biological root of each subset of cancer and then researching and developing the most effective meth-ods of treatment. It’s this approach that underpins the work being done by cancer researchers in Atlantic Can-ada.

“Once you start to understand the underlying biology of different can-cers then you can develop drugs that target the specific alterations that are present. It’s about knowing what you’re up against as researchers and

clinicians.” Atlantic Canada is deter-mined to make an impact with their research activities at a national and international level.

“We may be a small region but we have attracted some very good researchers. This helps us to recruit clinicians that want to participate in research, which in turn benefits our cancer patients. This is import-ant since patients are treated in the region and we must offer the best care available,” said Dr. Ouellette. “We can-not be dependent on other jurisdic-tions for something as important as cancer care.”

atlantic canada advances cancer care

JOE ROSENGARtEN

[email protected]

UnderStAndInG BIoLoGy

cAncer IncIdence

rodney ouellette, MD, phDpresident and Scientific director, Atlantic cancer research InstituteAssociate professor, department of Biochemistry, Université de Sherbrooke

Giuliana rancic knows what it means to be a survivor. After having been diagnosed with breast cancer in her 30’s and opting to have a double mastectomy, she has now become one of the biggest voices in breast cancer awareness.

GLADyS WASyLENChuk

[email protected]

saving lives through early detectionwomen in the 50 to 74 age range. The program uses the fecal immuno-chemical test (FIT) that will detect blood in the stool that is not visible to the naked eye.

The FIT can be done in the pri-vacy of the home and without any dietary restrictions, making it easy for people to get screened. To date more than 132,000 people have received invitations and the pro-gram already has a participation rate of 40 percent.

“Our early detection programs are working and every person screened is a potential life saved” Livingstone said. “That’s worth the short amount of time it takes to get screened.”

SHAre your experieNce WitH otHerS

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nEwscancer imaging: its present and future promise

Stopping the spread of cancer contrary to conditions like Hiv/ AiDS and influenza infection, cancer is not an invasion from the outside — it’s an internal threat.

When normal processes in our bodies go awry, the cancerous cells are essentially wearing the ‘same clothes’ as perfectly nor-mal cells. This makes cancer hard to identify, and even more diffi-cult to target with drug therapies which can successfully prevent recurrence.

Yet, we’ve become very good at treating the primary tumour. We now understand, better than ever before, how these tumour cells manipulate the body’s normal physiological

processes to support the primary tumour’s growth. We know that tumour cells are deranged normal body cells, so to speak, that do not fol-low the rules of normal cell growth and behaviour, such as multiplying into more cells.

prevention on various levelsThe issue we’re tackling now in can-cer research is how to prevent the cancer from coming back and spread-ing to other places in the body. The spread of cancer — called metastasis — causes more than 90 per cent of cancer-related deaths, which results from complications due to growth of cancer in secondary locations. Until recently, it was thought that tumour cells act quite independently

from the rest of the body tissues to drive this deranged spread, called malignancy.

We have now uncovered further evidence that there is an extensive and complex language that carries information back and forth between tumour cells and normal body cells, including the immune system cells, cells of the vascular system, fat cells and fibroblasts (which help the body heal wounds and are very abundant in the tissue surrounding tumours).  This is where exosomes, a relatively new area of focus in cancer research, come in.

Exosomes are tiny fragments of cells containing genetic material and proteins that interact with neigh-bouring cells and move throughout

the body. When exosomes from can-cer cells meet up with normal cells, they transfer genetic information and proteins to the normal cells, which then support the cancer. In a sense, the normal cells are tricked and given instructions to help the cancer cell survive, divide faster, and spread in the body.

recent studiesAt Mount Sinai Hospital’s Samuel Lunenfeld Research Institute, we recently published a groundbreaking discovery in this area, in the lead-ing scientific journal Cell. We found that normal cells surrounding the tumour send out whole paragraphs (exosomes) rich in information to stimulate the spreading of breast

cancer cells. In addition, we discovered a pro-

tein signal, called Cd81, which helps this process along. Next, our goals are to develop a tool (such as a blood test) that will detect this signal and target this protein with specific drugs.

Essentially, if we can stop cancer cells from communicating with nor-mal cells, we can one day stop the spread of cancer. We’ll be better able to target the imposter cancerous cells from ‘normal’ cells in our bodies.

DR. JEFF WRANA,

SENiOR iNvEStiGAtOR,

mOuNt SiNAi’S SAmuEL LuNENFELD

RESEARCh iNStitutE

[email protected]

Medical imaging allows physicians to look inside the human body without a scalpel and without tis-sue destruction. With modern tech-niques, imaging has the power to reproduce the human body virtually pixel by pixel.

This technology, when utilized by specifically-trained physicians and healthcare experts, plays an import-ant role in all phases of the cancer patient’s journey.

Managing cancerMedical imaging provides a wide range of information that drives cancer management. Magnetic res-onance imaging (MRI), computed tomography (CT or CAT scanning), ultrasound (US) and positron emis-

sion tomography (PET) are some of the technologies used in cancer imaging. Each imaging technology has its benefits and its limitations. Sometimes combining technologies (referred to as hybrid imaging) pro-vides information that can improve the ability to determine the stage of a cancer and therapy planning. We are already reaping the benefits of combining PET with CT, and initial research shows similar promise for combining PET and MRI.

We already understand the bene-fits of breast screening mammog-raphy for early breast cancer detec-tion, and colonoscopy for early colo-rectal cancer detection. Evidence is emerging suggesting that low dose CT scanning may play an import-ant future role in early lung cancer detection in patients at high risk.

Earlier cancer detection opens the opportunity for earlier treatments that have the potential to restore health. Interventional oncology looks promising as it includes pro-cedures that can destroy tumours without surgery. Image-guided destruction of tumours, called tumour ablation, is being clinically tested and may play an increas-ing role in the future of cancer management.

Future of imagingOver the last decade medical imaging has transitioned to digital, enabling the handling of the vast amount of data that modern tech-nologies produce. Computers are essential to existing and developing imaging technologies but are also essential in how imaging depart-

ments deliver patient care.The emergence of electronic

patient records and appointment booking provide the additional opportunity to electronically guide physicians in ordering the most appropriate examinations, help-ing to ensure patients only receive imaging tests when the results may benefit their care. We now also have the ability to accurately measure radiation doses, improving patient safety through monitoring lifetime radiation doses.

The future of cancer imaging is about hope and about quality. It is about doing the right test on the right person at the right time to get the best possible outcomes.

DR. JuLiAN DOBRANOWSki

[email protected]

medIcAL ImAGInG Dr. Julian Dobranowski chair, Access and Benchmarks Working Group, canadian Association of radiologistsStaff radiologist, St. Joseph’s healthcare

“earlier cancer detection opens the opportunity for earlier treatmentsthat have the potential to restore health”

iNveSt iN our HeALtHcAre’S

Future

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